LEONARD S FAGAN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125017005

License Status

EXPIRED

Business

First Name

LEONARD S

Last Name

FAGAN

Suffix

Business Name

LEONARD S FAGAN MD

Original Issue Date

06/22/1984

Effective Date

06/22/1984

Expiration Date

07/01/1986

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

Obstetrics & Gynecology

Ever Disciplined

LastModifiedDate

09/22/2006